English Outline

The GIANTT project (Groningen Initiative to Analyse Type 2 diabetes Treatment) is a regional initiative of health care providers and researchers focussing on the care delivered to ambulant patients with type 2 diabetes mellitus in the north of the Netherlands. The goals are to:

• improve the quality of care delivered to patients with type 2 diabetes mellitus

• reduce complications and improve the quality of life for these patients.

• To reach these goals, the GIANTT projects intends to

• provide the organisation, expertise and technical support to enable continuous monitoring of diabetes care based on routinely registered data

• offer benchmark reports to participating diabetes and primary care facilities using evidence- based quality indicators (process and outcome indicators)

• conduct scientific research to assess determinants of quality of care

• evaluate initiatives to improve the quality of care in (randomised) trials

• conduct studies to assess the impact of (changes in) care on patient outcomes (including morbidity and mortality) in a routine care setting

Setting and population
The GIANTT project started in 2004 as an initiative of the University Medical Center Groningen, the Martini Hospital Groningen, the General Practitioners of the Groningen region, the Diabetes Service from the General Practice Laboratory. In December 2011, more than 220 general practitioners practicing in 150 practices participate in the project. More than 20.000 patients with type 2 diabetes have been informed about the project and given the opportunity to object to the (anonymous) collection of their medical data.

Data collection
Data collection is based on routinely registered information in the various medical records. Automated procedures are used to collect data from the medical records. Important aspects are:

• validated procedure to select all known patients with type 2 diabetes

• method of data collection which is not dependent on specific registration routines of the health care provider

• continuous validation of collected data

• linkage of data from various sources without compromising the patients privacy

Research studies

• assessing the quality of treatment in relation to patient factors and outcomes

• identification of triggers for treatment intensification

• understanding and improving compliance in patients in need of multiple (preventive) drugs

• exploring the concept of total risk management from the practitioners’ and patients’ point of view

• evaluation of a patient-oriented intervention strategy to improve preventive care